This is a submission for a K23 Mentored Patient-Oriented Research Scientist Award. The applicant is a clinical psychologist and a developing investigator in the Cornell Advanced Center for Interventions and Services Research (ACISR). The goal of this application is to provide further interdisciplinary training and research opportunities to transition the applicant to become an independent investigator in interventions research. The career goal of the applicant is to develop interventions to improve the use and effectiveness of mental health services for older patients treated in a variety of medical settings. The career development objectives of this application are to learn about: 1. The assessment of treatment preferences and expectations in elderly primary care patients; 2. Treatment guidelines, and the assessment of ongoing patient engagement in and adherence to different forms of treatment; 3. Theories of health decision making and choice by patients, and how to optimize the treatment selection process within the primary care service delivery system; and 4. Research methodology, including the utilization of partial randomization research designs in clinical trials, and statistics. This training will provide the knowledge and skills necessary to conduct research that examines the impact of treatment preferences on treatment initiation, engagement in and adherence to treatment, and clinical outcomes of elderly depressed primary care patients.